Older People and Preventive Screenings

Respect for Older Patients
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I've been speaking for healthcare organizations since 1994. Before that, I served in vice president positions at two hospitals.


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What’s the best way to communicate that preventive screenings are no longer recommended due to someone’s age? How can we convey the information in a way so the person does not feel they will soon be put out to pasture?

The journal Health Expectations published results of a qualitative study of the perspectives of women who had expressed concern about being discontinued from mammography screening.

When told they’d reached the age limit for preventive screenings, the study participants felt more susceptible to breast cancer, late diagnosis, and death.

“I full understand that the healthcare system can’t test everything and everyone into eternity. I know that but personally I was insulted. To be written off. To be deemed out” said one participant.

Study authors cited previous research that revealed older adults of all genders continue to participate in cancer screening despite their knowledge of decreased likelihood of benefit and increased likelihood of harm.

“This indicates that emotions and intuition play a role in screening decisions rather than evidence about potential benefits and harms.”

Researchers at Johns Hopkins studied this issue. You can read their recommendations here:  https://www.hopkinsmedicine.org/news/newsroom/news-releases/2019/07/study-probes-how-to-tell-elderly-patients-not-to-bother-with-cancer-screening.

Christy Arthur MD had this to say:

“I think this conversation has to be framed really carefully. Understanding the benefit of the screening (and a bit of statistics), really helps. Patients can easily feel like “no one cares if I get cancer now”, when in actuality it is that the screening test is no longer helpful -it gets too many false positives and causes unnecessary stress, or other health concerns render treatment too dangerous. A personalized conversation is essential.” 

What do you or would you say to an older person who has reached the age limit for recommended preventive screening?

Would you tell them before or after their last recommended screening?

If you were a patient reaching the age of discontinuation, how would you want to be informed?



#respect #preventive care #geriatrics #cancerscreening



January 25, 2024

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